Bishops Corner

Updated 13 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’

This inspection which took place on 4 September 2017 and was unannounced. The inspection team consisted of one inspector.

At the inspection in January 2017 a number of breaches were identified and the service was rated requires improvement. The Care Quality Commission (CQC) took enforcement action and issued a Warning Notice after the inspection as the provider had not ensured good governance. We also found four further breaches in relation to person centred care, dignity and respect, safe care and treatment, and meeting nutritional needs.

Before our inspection we reviewed the information we held about the home, including previous inspection reports. We looked at information and notifications that had been submitted by the home. A notification is information about important events which the provider is required by law to tell us about. We also reviewed any other information that had been shared with us by the local authority and quality monitoring team. CQC had not requested a Provider Information Return (PIR) to be completed. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

At the time of the inspection there were nine people living at Bishops Corner. We spoke with five people living at Bishops Corner and four staff. This included the acting manager, acting deputy, senior and support workers.

We spent time looking at care records for two people to get a picture of their care needs and how these were met. We also looked at documentation in further care files to follow up on specific health conditions and areas of care for people, including risk assessments.

All Medicine Administration Records (MAR) charts were checked and other medicine documentation and procedures. We read daily records, charts and handover forms and other information completed by staff. We reviewed three staff files and other records relating to the management of the home, such as complaints and accident / incident recording, quality assurance and audit documentation.

Updated 13 October 2017

Bishops Corner is a care home providing residential care for up to nine adults with learning disabilities. In particular they provide residential care for people with Prader-Willi Syndrome (PWS).

This comprehensive inspection was undertaken on 4 September 2017 and was unannounced.

At the inspection in January 2017 a number of breaches were identified and the service was rated requires improvement. The Care Quality Commission (CQC) took enforcement action and issued a Warning Notice after the inspection as the provider had not ensured good governance. We also found four further breaches in relation to person centred care, dignity and respect, safe care and treatment, and meeting nutritional needs. This inspection took place on 4 September 2017 and was a full comprehensive inspection to check the provider had made suitable improvements to ensure they had met regulatory requirements. We found that appropriate actions had been taken and issues had been addressed. The provider was now meeting the regulations.

There was no registered manager at Bishops Corner. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

A new acting manager had begun working at Bishops Corner and was starting the process of registering as manager with CQC. Staff told us the current acting manager had made positive changes and impact during their time at Bishops Corner. The acting manager had previously worked at a number of services owned by the organisation so they knew staff and people living at Bishops Corner well. The acting manager was going to be registering as manager over three services owned by the provider. A clear structure was in the process of being implemented to provide consistent management cover. The acting manager had a timetable to ensure staff knew where they were and to enable them to provider management support at each of the three services. However, there needed to be a clear structure to support them with this and to make sure this was consistently maintained. At the time of the inspection some of the support roles had not yet been fully recruited. Therefore this is something that will need to be monitored to ensure continued improvement.

The provider had safe recruitment processes and appropriate checks took place before people began work at Bishops Corner. New staff completed a period of induction and all staff received training including safeguarding and PWS specific training to ensure they were able to meet the needs of people living at Bishops Corner. Supervision was taking place to support staff, as well as staff, resident and relative meetings and questionnaires to improve communication. There were enough staff to meet people's needs.

People’s confidentiality was maintained and records were kept securely. People received care which was assessed, planned and reviewed to ensure their needs were met and to reflect their preferences. Support plans included advice about people’s nutrition, medicines and support needs. Staff had access to relevant information about people; this meant they knew people and their care needs well. Staff communicated with people in a caring and supportive manner. Staff knew people well and people were treated with respect and dignity. People’s nutrition was monitored and reviewed based on their individual needs. Changes were introduced slowly to ensure this did not cause undue anxiety for people.

People were involved in decisions and choices when it was appropriate. Mental Capacity Act 2005 (MCA) assessments were completed as required and in line with legal requirements. Staff had attended MCA and Deprivation of Liberty Safeguards (DoLS) training.

People told us they enjoyed the activities provided and people were supported and encouraged to maintain their independence and attend work placements.

People spoke positively of the improvements which had taken place since the previous inspection and spoke highly of the new acting manager. Staff felt supported and people’s views had been sought and responded to.

There was on-going maintenance for the home, servicing of equipment and fire safety checks had taken place. Individual and environmental risk assessments were in place when risks to people’s safety had been identified. A structured system was in place for responding to and recording accidents and incidents. Protocols were in place for people who required one to one support. People were supported to attend health appointments and referrals were made to other health professionals if needed.

A complaints procedure was in place. People told us they would be happy to raise concerns if they needed to. Notifications had been completed appropriately to CQC and other organisations when required.